The anterior cruciate ligament (ACL) is a major component of the soft tissue in a human knee that is responsible for stability of the knee. In addition to the ACL, several other ligaments provide stability including the posterior cruciate ligament (PCL) and the medial and lateral collateral ligaments (MCL/LCL). It is not uncommon for a person to rupture or tear the ACL during various types of physical activities including sports, work, and the like. The tear or rupture can be caused by trauma such as impact, or by abrupt stopping or turning movements which cause exceptional forces to be transmitted to the ACL. Typically a torn or ruptured ACL cannot be repaired using conventional soft tissue repair procedures such as suturing, stapling, etc. It is necessary to replace the ACL with a graft. The graft may be an autograph harvested, for example, from the patient's patellar tendon or hamstring tendon, an allograft harvested from a cadaver, a xenograft, or an artificial man-made tendon. Tissue-engineered ligaments may also be available. In a typical ACL reconstruction, axial tunnels are drilled into the patient's tibia and femur by the surgeon using conventional surgical drills, drill guides and instruments. Once the knee is prepared, the graft is then inserted by the surgeon into the tibial and femoral tunnels, such that one end of the graft resides in each tunnel. The graft is adjusted by the surgeon to provide the desired range of motion. Finally, the graft is secured at both ends in a conventional manner to complete the ACL repair or reconstruction. For example, the graft ends may be secured with conventional interference screws, etc. An alternate method of securement is to use a cross-pin, in particular a femoral cross-pin. In this type of procedure, a transverse hole is drilled into the end of femur such that it intersects the femoral tunnel, and a guide wire is threaded through the transverse tunnel. A cannulated cross-pin is then inserted into the transverse tunnel over the guide wire and underneath a looped end of the graft in order to secure the graft in the femoral tunnel. The guide wire is then removed. If desired, the other end of the graft may be secured in the tibial tunnel by a tibial cross-pin in a similar manner.
Although the cannulated cross-pins known in this art are sufficient and adequate for their intended purposes, there is a continuing need in this art for improved cross-pins and surgical techniques. For example, there is a need for novel cross-pins that provide uni-cortical fixation and intraoperative removal or revision, eliminate or reduce the need for multiple size (length) implants, and simplify the need to make measurements and calculations in order to determine appropriate length.
Accordingly, there is a need in this art for novel cannulated cross-pins for use in ACL reconstruction procedures.